Curricular Designs for Sleep Programs

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Curricular Designs forSleep Programs
Tom Smalling, MS, RRT, RPFT, RPSGT
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Overview

• How do I get started?
• PSG Program Goals and Strategies
• CoARC PSG accreditation standards
• Sample program outlines
• Sample instructional units
• What resources are at my disposal?
• Question and answers

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How do I get started?

• Go to www.coarc.com, download and review the
  self, study, curriculum guide and its associated
  documents.
• Obtain support/feedback from program director,
  dean, advisory committee, and medical director.
• http//www.absm.org/diplomates/listing.htm
• Network with colleagues.
• Perform a needs assessment
• Assess your resources

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Resource Assessment

• ADVISORY COMMITTEE
• Develops, promotes, supports and evaluates the
  goals of the Program.
• MEDICAL DIRECTOR (S)
• Effective medical direction/administration for
  the program to ensure that current standards of
  medical practice are met.
• FACULTY
• Effective laboratory, classroom and clinical
  instruction effective examples for students in
  all three domains.
• SUPPORT PERSONNEL
• Appropriate and effective clerical support for
  the program.
• FACILITIES
• Adequate classroom, laboratory, office space and
  accommodations.

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Resource Assessment

• LABORATORY EQUIPMENT AND SUPPLIES
• Provide students with the equipment and supplies
  sufficient to prepare them for clinical practice.
  
• LEARNING RESOURCES
• Support student needs for supplemental reading,
  electronic and print reference materials,
  research and computing resources.
• FINANCIAL RESOURCES
• Adequate fiscal support for the retention of
  personnel and the acquisition and maintenance of
  equipment and supplies
• CLINICAL RESOURCES
• Provide a sufficient variety of clinical tasks
  and procedures to allow for student mastery of
  the program's required clinical competencies.
• PHYSICIAN INPUT (Instructional)
• Assure that program graduates can communicate and
  work with physicians in a confident and
  professional manner.

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PSG Program Goals

• Facilitate the entry of working therapists
  wishing to cross-train into this specialty.
• Provide graduates with the opportunity to obtain
  specialized training and be eligible to take the
  national credentialing exam upon completion of
  the certificate.
• Offer a means for non-matriculated allied health
  professionals the ability to cross-train into the
  field of polysomnography bridge curriculum.

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Curricular Strategies

• Instructional units, curriculum content and
  length, and documentation of student progress
  must be designed to enable achievement of program
  goals and objectives.
• Instructional units must be based on a structured
  curriculum which includes learning goals, course
  objectives, and competencies required for
  completion of the program.
• Curricular content must be designed to supplement
  as well as take advantage of the comprehensive
  didactic, laboratory, and clinical instruction
  already established in a respiratory care
  curriculum.
• For instance, while respiratory care program
  curricula provide significant instruction on
  positive airway pressure (PAP) therapy,
  respiratory therapy students enrolled in an
  optional polysomnography program would learn
  about the distinct application of PAP devices
  within the context of the sleep laboratory.

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Curricular Strategies

• Course content should be periodically reviewed
  and revised to reflect both the work performed by
  sleep technologists as assessed by job analysis
  surveys and the material covered in national
  credentialing examinations.
• Faculty teaching polysomnographic-specific course
  content should be appropriately credentialed
  (e.g., RPSGT or REEGT) and should utilize
  continuing education and other educational
  opportunities to maintain and upgrade their
  professional, instructional and administrative
  abilities.
• Both material and personnel resources must be
  adequate to fulfill the needs of the program.

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Curricular Strategies

• Learning and clinical resources must be
  appropriate to the programs goals and should be
  available to students outside of regular
  classroom hours.
• Physician input, preferably from American Board
  of Sleep Medicine (ABSM) Diplomates, should also
  be adequate.
• Program competencies should provide the basis for
  deriving the objectives and activities
  constituting the program's curriculum. 
• The competencies stated and the curriculum
  objectives derived should be consistent with the
  level of practitioner preparation delineated in
  the program's goals, and should encompass the
  knowledge, technical expertise and behavior
  expected of graduates.

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Curricular Strategies

• The curriculum must include an appropriate
  sequence of learning experiences consisting of
  classroom and laboratory presentations,
  discussions, demonstrations, and supervised
  laboratory and clinical practice that progresses
  in sequence from entry-level cognitive,
  psychomotor, and affective components of
  instruction to more advanced levels.
• Clearly written course syllabi which describe
  learning objectives and competencies must be
  developed for each of the didactic, laboratory,
  and clinical components.
• Clinical affiliates should conform to
  professional standards, such as those established
  by the AASM and by other health care accrediting
  entities where appropriate.

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Curricular Strategies

• The above strategies are not meant to be
  all-inclusive, but are attentive and consistent
  with current accreditation standards and
  practices.
• The polysomnography curriculum should be designed
  in such a way as to addresses the unique
  characteristics and constraints of each
  respiratory therapy program.
• What works well for a university-based,
  baccalaureate respiratory therapy program with
  10-week modular curricula, for example, will not
  necessarily work for a semester-based, associate
  degree community college program.

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CoARC PSG Accreditation 2003 Standards

• For those programs providing a Polysomnography
  specialty option, curricular content should be
  periodically reviewed and revised to reflect both
  what is being done by Polysomnographic
  Technologists in the workplace (the Board of
  Registered Polysomnographic Technologists, Inc.
  (BRPT) Job Analysis) and the material covered in
  the appropriate national credentialing
  examination (BRPT Examination Matrix), which are
  nationally accepted standards of roles and
  functions in Polysomnography.
• In meeting the requirements of state and
  institutional accreditation, the following units,
  modules, and courses of instruction may be
  included

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CoARC Focused PSG Instructional Units

• Clinical Polysomnography-Sleep Staging Pattern
  Recognition
• Electroneurodiagnostic Electronics
  Instrumentation
• Electroneurodiagnostic Recording Techniques
• Electrographic and Clinical Correlations
• Pharmacology for Treatment of Sleep/Wake
  Disorders
• Neuroanatomy and Physiology
• Anatomy and Physiology related to sleep and sleep
  disorders
• Sleep disorders classifications
• Patient and equipment preparation for
  Polysomnography
• Fundamentals of Polysomnographic instrumentation
• Polysomnographic monitoring techniques
• Multiple Sleep Latency Testing/Maintenance of
  Wakefulness Testing
• Scoring of sleep, sleep related events and report
  generation
• Fundamentals of therapeutic intervention during
  Polysomnography
• -Supplemental 02
• -PAP titration (continuous or bi-level)
• Other surgical, non-surgical and behavioral
  treatment modalities

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CoARC PSG Curriculum Guide

• It is acknowledged that there are variations in
  academic calendars as well as other curricular
  constraints among respiratory therapy programs.
  As such, the following are minimum curricular
  requirements for completion of the certificate
  program
• A 2-credit (50 contact hours) lecture/lab course,
  followed by a 2-credit (80 contact hours)
  clinical rotation in the first semester.
• The second semester will consist of a 2-credit
  (50 contact hours) lecture/lab course, followed
  by a 2-credit (80 contact hours) clinical
  rotation.

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SAMPLE PROGRAM OUTLINE FOROPTIONAL
POLYSOMNOGRAPHIC TECHNOLOGY CURRICULUM

• LAST SEMESTER (YEAR 1)
• OBSERVATIONAL CLINICAL IN A SLEEP LABORATORY
• FIRST SEMESTER (YEAR 2)
• PSG LECTURE I -------------------------- 20
  contact hoursPSG LAB I --------------------------
  --------- 30 contact hours
• PSG CLINICAL I --------------------------- 80
  contact hours
• SECOND SEMESTER (YEAR 2)
• PSG LECTURE II -------------------------- 20
  contact hours
• PSG LAB II ----------------------------------- 30
  contact hours
• PSG CLINICAL II --------------------------- 80
  contact hours
• TOTAL PROPOSED MINIMUM CONTACT
  HOURS 260

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SAMPLE PROGRAM OUTLINE FOROPTIONAL
POLYSOMNOGRAPHIC TECHNOLOGY CURRICULUM

• Course No. Course Title
  Semester Hours
• First Semester
• MATH-1140 Applied Algebra 02
• BIO-1100 Introduction to Biological
  Chemistry 03
• ENG-1010 English Composition I 03
• BIO-1430 Anatomy and Physiology-I 04
• RESP-1310 Cardiopulmonary Physiology
  03
• RESP-1410 Beginning Polysomnography
  02
• Subtotal 17
• Second Semester
• BIO-1440 Anatomy and Physiology - II
  04
• RESP-1420 Intermediate Polysomnography-I 03
• RESP-1934 Directed Practice-I
  03
• Subtotal 10
• Third Semester
• RESP-1440 Neurophysiology of Sleep 02
• RESP-1430 Intermediate Polysomnography-II 03
  
• RESP-2934 Directed Practice-II
  03
• Subtotal 08

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TYPICAL SEQUENCE OF INSTRUCTIONAL UNITS FOR PSG
PROGRAM

• Overview/Medical Terminology
• Patient and Laboratory Safety Issues
• Procedures/Documentation for Initiating Sleep
  Studies
• Electrode Theory/Instrumentation
• Patient Preparation Procedures/International
  10-20 System
• Neuroanatomy and Physiology
• Intro to sleep architecture/sleep stages
• Ancillary equipment application
• Signal processing
• Montage selection/Equipment calibration
• Physiologic Calibrations/Lights Out Procedures
• Sleep disorders pathophysiology
• Monitoring procedures

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TYPICAL SEQUENCE OF INSTRUCTIONAL UNITS FOR PSG
PROGRAM

• Sleep microanatomy and architecture
• PSG record staging (RK/AASM)
• Event recognition
• Limb movement
• Respiratory
• Cardiac
• Neuro
• Sleep Pharmacology
• Sleep Calculations
• Pediatric PSG
• MSLT/MWT
• Therapeutic Interventions (PAP, surgical,
  non-surgical)
• Report generation

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BRIDGE CURRICULUM FOR NON-RT CREDENTIALED
HEALTH PROFESSIONALS

• The program should evaluate the applicants
  educational background and content areas covered
  on the respective credentialing exam for which
  they have demonstrated minimal competency.
• Applicants that have completed prior coursework
  in the Focused Polysomnographic Technology
  instructional units outlined in the CoARC 2003
  Standards and Guidelines (p. 7) should
  demonstrate minimal competency in such
  instructional units via challenge examination.

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What resources are at my disposal???

• www.coarc.com
• Accreditation and curriculum
• Sample list of typical equipment and supplies
• www.aarc.org
• Specialty sections in polysomnography/education
  (sleep_at_aarc.org)
• Smalling, T. (2003). Education resources for the
  respiratory therapist interested in sleep
  technology. AARC Times 27(5). pp 14-18.
• www.brpt.org
• Credentialing
• www.aasmnet.org
• Educational resources

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Contact Info

• tsmalli_at_notes.cc.sunysb.edu
• 631-444-3241 office
• Respiratory Care Program
• Stony Brook University
• HSC Level 2 Room 410
• Stony Brook, NY 11794-8203